No abstract

predictors of non-conventional laparoscopic approach to leiomyoma hysterectomy. Our findings suggest that there is a differential access to LH procedures among the US population which may be, in part, a result of racial and socioeconomic differences and centralization of laparoscopy services in urban areas.

Objectives: To assess the efficacy and safety of atosiban in pregnant women under threat of preterm birth. MethOds: A systematic review was carried out, inclusion criteria were adult pregnant women diagnosed with preterm labor threat with the following characteristics: regular uterine contractions lasting at least 30 seconds, contraction frequency greater than 4 every 30 minutes, cervix dilatation from 1 to 3 cm, gestational age from 24 to 33 weeks and normal fetal heart rate (110 -160 bpm). Atosiban was set as intervention and the comparators were nifedipin, indomethacin, terbutaline, fenoterol and placebo. Assessed outcomes were: Gestational age at birth, delay in the timing of birth, neonatal mortality, neonatal respiratory distress syndrome, intraventricular hemorrhage, periventricular leukomalacia, rate of maternal adverse events, rate of neonatal complications. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. The comparison measurements found on studies were extracted in order to perform a network meta-analysis. Results were expressed through forest plots. Results: 11 studies were included in network meta-analysis, all of them were randomized controlled clinical trials. The results showed that atosiban has the greater probability of being the most effective alternative on the following outcomes: delay in the timing of birth (0.81), neonatal mortality (0.85) and rate of maternal adverse events (0.99). cOnclusiOns: Atosiban showed similar efficacy for delaying labor in women with preterm labor threat with comparators. However, it showed a greater safety profile with respect to maternal adverse events and a similar level compared to nifedipine for neonatal complications.